Racial and ethnic disparities in post-stroke depression detection

✍ Scribed by Huanguang Jia; Neale R. Chumbler; Xinping Wang; Ho-Chih Chuang; Teresa M. Damush; Randi Cameon; Linda S. Williams

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 116 KB
• Volume: 25
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/gps.2339

✦ Synopsis

Abstract

Objectives

Post‐stroke depression (PSD) is common among stroke survivors and is associated with increased morbidity and mortality. Little is understood about racial/ethnic differences in PSD detection. This study assessed the racial/ethnic disparities in PSD detection in a national cohort of Department of Veterans Affairs (VA) acute stroke patients.

Methods

The study included VA patients who: received inpatient care for acute stroke within 2001; survived >60 days post‐index hospitalization; had an index stay <365 days; and were confirmed VA healthcare enrollees. PSD was established if a patient had a depression diagnosis in VA or Medicare inpatient or outpatient files, or was dispensed an antidepressant with guideline recommended minimum daily dosage during the 12 months post stroke. A multivariate logistic regression model was fitted to estimate the effects of race/ethnicity on PSD detection, adjusting for sociodemographic and clinical factors.

Results

The study cohort (N = 5825) was comprised of 66% white, 22% black, 7% Hispanic, and 6% for all other racial/ethnic categories. Among these stroke patients, 39% had PSD. Black and ‘all other’ racial/ethnic categories were significantly less likely to be diagnosed with PSD than non‐Hispanic whites, even adjusting for potential risk factors.

Conclusion

White, non‐Hispanic VA acute stroke patients were more likely to be diagnosed with PSD, even controlling for sociodemographic and clinical characteristics. Whether these findings suggest racial/ethnic differences in symptom endorsement by patients or in symptom recognition by providers is not clear. Copyright © 2009 John Wiley & Sons, Ltd.